Early Stage Breast Cancer in Older Women: Predictors Outcomes of Therapy
Abstract
This study uses secondary data bases (SEER tumor registry records and Medicare claims data) to examine the relationship of primary breast cancer treatment to specific outcomes. Our studies of the accuracy and completeness of a Medicare claims algorithm for determining breast cancer surgery show that 94% of SEER patients undergoing breast cancer surgery are identified by a combination of Medicare claims. The physician part B claims identify a higher percentage of patients than do the inpatient claims alone. Using SEER and Medicare claims, we have determined that a substantial minority of women with early stage breast cancer undergo care that does not meet the 1990 NCI Consensus statement guidelines. Women who underwent breast-conserving surgery but neither axillary node dissection nor radiotherapy were at significantly higher risk of death, after adjusting for age, tumor size, and comorbid conditions. In preparation for studying the intermediate outcome of treatment for recurrent disease, a methodology has been developed for categorizing Medicare claims into those tor initial treatment and those for recurrent disease treatment. The methodology utilizes a statistical model of number of claims and months after diagnosis to classify claims.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 1999
- Accession Number
- ADB258112
Entities
People
- Ann B. Nattinger
Organizations
- Medical College of Wisconsin